13th February 2025

A 72-year-old lady presents with severe pain in her right eye that came on an hour ago while she was sitting in the lounge watching television, with the lights down low.

A 72-year-old lady presents with severe pain in her right eye that came on an hour ago while she was sitting in the lounge watching television, with the lights down low. Since it started, she has had paracetamol and codeine which have not improved her symptoms. She has vomited twice due to the pain. On examination, you note a fixed, dilated pupil in the right eye and her visual acuity is 6/36 (from a baseline of 6/6 in that eye. The left eye is normal.  What is the most important first-line medication? 

Select the SINGLE most appropriate option from the list below. Select ONE option only.